melisgood

What is your view or experience with taking care of a patient on comfort care when you know the family and doctors are trying to assist the patient in dying? I took care of a patient who was on a morphine drip. He was a young trauma patient and the ventilator had already been removed and he was a DNR. The order was to increase the morphine every hour as needed by 2mg/hr. The family was requesting we increase it every hour or two (while they were at the bedside) and he did not have any obvious signs of increased pain. At the end of my shift he was up to 74mg/hr! The doctor did put a max dose of 80mg/hr. On one hand I understand the family wanting to end their pain of seeing their loved one like this, but on the other, I felt like I was assisting in killing this patient. What would you do?

Also, any advice on best place to take CE credits if unemployed? Would it make sense, if I decided 12hour shifts aren't for me, to stay home for say 6 months and then look for a job outside the hospital? Any specific areas other than home health that I should be considering?

Per diem may be something to look into. I'm assuming it varies by hospital, but are you scheduled specific days or are you on call? Also, do you usually work any floor qualified or only one specific floor? Do you have to attend staff meetings (unit specific) or are there per diem meetings? How much more is the hourly pay usually? Would I contact the nursing office or HR to inquire about possibilities?

Hello all,Here's a little background to help you help me:I graduated in June 2009 as a RN. I've been working on a telemetry floor at a near by hospital since graduation. I have a 2.5 year old daughter. After she was born I switched from full time to part time due to extreme colic and exhaustion on my part. I currently work 2 12-hour shifts a week and have full benefits. My husband resenty started a new job with a very good salary and benefits. We have been discussion the option if me staying at home after our second is due in a few months. I am really torn what to do. Part of me wants to stay home and enjoy being a mommy full time for at least the first year, the other part of me doesn't want to give up my position at work. The floor I work on is hard and we have a hard time retaining nurses. I have been temper to look elsewhere for employment in the past. I am leaning towards working through this pregnancy and then not returning after maternity leave. Is this frowned on by an employer? Is it better if I quit before maternity leave? Do I tell the board that I am inactive if I quit? What do I need to do to keep my license up tondate should I decide to return to work? If I did volunteer type work would that benefit my resume so there isn't a large gap in employment? What is the best type of nursing position for a mother with young children? 2 shifts a week isn't bad, but I'd love to work less than 12 hour shifts. Home health? If I go that direction will I have a hard time getting a job at a hospital 5-10 years down the road? I don't want to loose my skills or mess up and give up a good position. Please give me any advice you have to offer! TIA!

I stand by my belief that there is nothing wrong with responsible use. What I'm questioning is the risk of likely ones license. Does anybody know where the Bon stands regarding legal use?

Does anyone know if medical marijuana in California is an option for a practicing RN? It has been recommended to me from a doctor as an alternative to other medication, but I do not want to risk my license. If I understand the law correctly, if I get tested at work and come out positive I could be fired (as many people have been fired from other positions due to the federal government not making marijuana legal. Obviously, caution would be taken, as with any narcotic and I am talking about not being affected while at work. Has anyone approached the board of nursing about this? I am considering asking since I am not using, just considering my options. Tia!

Maybe I misunderstand accreditation? My understanding is CCNE or NLAC is good. NLAC accredits associates-masters programs and CCNE only BSN and above. ? Anyone care to comment on this?

I've narrowed down my choice of online RN-BSN programs to either Grand Canyon University or American Sentinel. They are both CCNE accredited. GCU would require me to take 12 5-week classes (60 weeks=36 credits). They charge $450/credit. There is also a $400 one-time electronic fee and $75/class online text book fee. Total cost per class= $1,458. Total cost for program= $17,500. Classes start about every week. I was told to expect to spend on average 10-12 hours/week/class studying. American Sentinel would require3 me to take 10 8-week classes (80 weeks=30 credits). They charge $370/credit plus $95 one time new student fee + $100 graduation fee + purchasing testbooks aprox $150/course. Total cost per class= $1,270. Total cost for program=$12,700. Classes start every 8 weeks. i was told to expect to spend on average 5-10 hours/week/class studying I am planning on getting $3,000/year reimbursed from my employer so I am looking for a flexible program that I can take 3-4 classes/year. I have a baby at home and don't want to take too much time away from her. Which school do you think I should attend based on this info? TIA!

Hey Everyone, I've been doing hours and hours of research on RN-BSN online programs. I've narrowed it down to Grand Canyon University, Chamberlain University, University of Texas Arlington or American Sentinel. I am still compiling info on these colleges...pretty much have all the info on GCU. Can anyone tell me first hand experiences with any of these programs or maybe something you've heard from a colleague? Any advice or tips are appreciated. TIA!

I injured my back doing nothing in particular. I have made it very clear btw that i am not blaming my work fornyhis injury. I run and have a young child. It was a progressive tightening and stiffness in my lower back that turned into sharp stabbing/spasming pain. After about 4 days and it only getting worse, even after a couple chiropractor visits, I went to the docs. Drags were done and my spine is fine, it's just bad back spasms/tightness. I called the nursing office yesterday and asked if it were possible to be put on light duty. They transferred me to employee health and the NP I spoke with told me she wanted the note my doc wrote excusing me from work (because I mentioned it) and she said I need to go back to my doctor and get a note saying when I can return to work. This message was given to me by the NPs secretary and I told her I felt good enough to work and the doc wrote the note in case I wasn't feeling up to working. I left the NP a message saying I felt ok to come in and didn't want to start this process. I also notified the charge nurse the night before my shift to ask for a lighter patient load if possible. I showed up for work this morning with a back support hidden under my scrubs. I got a call 30mins into my shift from the NP at employee health telling me I had to give her the note and go home for the day. Obviously my supervisor wasn't happy having to call in another nurse to work my shift and she said I didn't go by policy because I should have called her. I understand what I started now and kinda wish I kept my mouth shut. I'm not back to work for a few days so I plan on making a doc appointment to get a note to return to work. I'm worried my back pain is still bad but am worried I need to go back to work. My supervisor specifically said my doctor needs to write ok back to work without restrictions. What if I need light work for a while? I work on a step-down floor and it's very heavy. Any advice? Tia!

I called my charge nurse this morning and told her. She said there is a social worker on the case already and she will pass on the info to her if they need to contact me. Thanks for all the replies.

I went home today from work wondering if I should report what my patient said to me. She was crying and told me her mother was going to get her husband arrested. I asked, "why do you think she'd have him arrested?" and she sobbed, "because he hits my child...She's 7 years old." Should i report this? Also, in report I was told rumors of the husband treating her badly. Should I have asked her if he ever hits her? I feel like I should have done more. Is it too late?

So, long story short, I'm unhappy with my job. I got this job right after school after getting my ADN 2 years ago. I work on the busiest floor of the hospital and it is very difficult to keep up and finish on time. Often we end up staying overtime past our shift without being approved to get paid. I have been thinking about giving my resignation and completing my BSN while staying home with one year old daughter. I currently have a part time position, which I love so I'm worried about leaving a good thing. I'm miserable lately and find myself sick the day before working and having to take Xanax to fall asleep the night before a shift. Do you think it will make sense to a future employer that I quit to stay home with my daughter and continue my education? Any online programs that you can recommend? Will i need to do clinicals? What kind of studying/tests/papers should I expect? Tia!

So, my best friend just so happens to be a lawyer and I spoke with her today about a class action lawsuit. On my floor they also have a book were supposed to sign for each pay period stating that we took our 2 15 minute and 30 minute meal breaks and that we are waiving our rights for our second 30 minute meal. We are told if we do not sign we won't get paid. We only take one 15 minute and one 30 minute break and have never been offered a second 30 minute break! I haven't signed this book in months....and I don't think I will. The truth is even if we were offered a second 15 or 30 minute break during our 12 hour shift, no one could afford to be away from charting and patient care that long for fear of staying even later! Anyone know of a lawsuit like this and how it ended? I would like to make a positive change instead of just running if I can. Also, my union rep suggested I fill out a form during a crazy shift that's for objecting to patient assignment due to high acquity and workload. You include how many new admits, blood transfusions, NGTs, pain mess etc during your shift. I am going to encourage others on my floor to fill this out when I see someone complaining or running around like a maniac (every shift). This should be interesting to see how this ends.

What is a time stamp? We do paper charting and rarely do we chart as we go. We write what time something happened, not what time we are actually making the entry. Whoever stays over usually finishes up paperwork in the back. So, what should I do?